Treating Depressed Workers Could Make Good Business Sense : Health: A mood disorder expert at UCSD believes corporations could save money in the long run by helping employees to improve their mental health.

Former National Institute of Mental Health Director Dr. Lewis Judd offers strong evidence that it makes economic sense for business leaders to help depressed employees to regain their mental health.

During 1992, the pervasive mood disorder will cost businesses an estimated $27 billion in depression-related absenteeism, production losses and increased health-care payments, said Judd, one of the nation’s leading mood disorder researchers. Depressed employees who aren’t treated will cost San Diego businesses an estimated $297 million during 1992, Judd said.

Yet, corporate willingness to help combat the mood disorder that affects 5% of the adult population remains “spotty at best,” said Judd, now chair of the Psychiatry Department at the UC San Diego School of Medicine.

“We’re knocking at a door that remains largely locked,” Judd said. “Many corporations . . . are hunkering down and hoping that it will all go away. But the fact is, it won’t go away.”

If anything, Judd said, the economic impact of depression on the business world likely will increase. Judd based that prediction on a study conducted during the late 1980s that suggests that the corporate world harbors one of the nation’s largest undiagnosed populations of depressed individuals.

While the study, conducted at Westinghouse Electric Corp.’s Pittsburgh headquarters, was limited in scope, it indicates that depressive disorders among professional workers could be “at least double” the national average, Judd said.

The ongoing economic downturn, which has generated high unemployment and sent consumer confidence tumbling, is also increasing the number of depressive episodes. It also “increases stress and uncertainty, which results in increased depression, no question about it,” Judd said.

While at NIMH, Judd helped found Depression/Awareness, Recognition and Treatment (D/ART), a publicly funded program that is designed to reverse the widely held, but mistaken, belief that depression is a character flaw or personal weakness.

D/ART comes at a time when cash-strapped companies are “capping and reducing health-care costs,” Judd acknowledged. “And here we are with a new population that they may have been ignoring or not covering at all with their medical coverage.”

That short-term focus is frustrating, Judd said, because “not only is treatment the humane and right thing to do . . . it will provide cost savings in the long-term.”

Depression is driven by a patient’s biological makeup, but doctors now know that episodes can be triggered by stress, the loss of a loved one or an economic recession that gnaws away at consumer confidence.

In 80% of cases involving depression, prompt intervention in the form of medication and/or therapy is successful. Depression “is a definitive disease for which there is an onset and a termination,” Judd said. “There are highly specific treatments.”

Yet, while most depressions are easily treated, only a third of depressed Americans receive proper treatment, said Judd, who served as director of the NIMH for three years before returning to UCSD in 1991.

That low treatment rate is driven by the fact that depressive disorders are widely misunderstood. And, depressed individuals often are misdiagnosed by primary care physicians who lack training needed to identify and treat mental disorders.

That lack of understanding “is the residual of centuries of stigma and misunderstanding,” Judd said, “(which is) gradually beginning to change as people in this country recognize that mental disorders are not visitations of the devil or a fault of the individual.”

Depression symptoms--including persistent sad or anxious moods, loss of interest in daily events, fatigue, change in appetite and chronic pain--can easily disrupt a workplace, according to doctors.

“There are many times when someone has been a good, productive worker and all of a sudden they aren’t performing as well,” said Mark Rapaporte, a medical doctor at UCSD’s clinical research center who has treated many cases of depression. “The boss doesn’t know exactly what’s going on.”

Rapaporte recently used therapy and medication to help a Southern California aerospace industry worker who “was becoming more and more desperate and alone.” A model employee for more than five years, the man suddenly thought that everyone was angry with him,” Rapaporte said.

The man’s productivity plummeted and his increasingly bizarre behavior alienated co-workers.

One day the man cornered his boss to find out “why no one liked him anymore,” Rapaporte said. A relatively quick program that included medication and therapy brought about the return of an employee “who was a good worker, who has been doing very well,” Rapaporte said.

Corporate Employee Assistance Program managers say that kind of early intervention can generate dramatic cost savings.

According to a 1989 Pacific Bell survey, the company spent an average of $4,500 on a depressed individual’s medical bills. If a depression resulted in disability payments, the cost rose by an additional $5,700.

Pacific Bell, which offers assistance through its medical programs and an Employee Assistance Program, estimates that the medical costs of a depressed employee’s family exceed a non-depressed individual’s health-care costs by $2,500.

Medical costs can be driven up in part by “expensive medical work-ups that are conducted to find out why an employee’s mind and body are quitting,” said Connie Herrell, executive director of Turning Point Center, a clinic in downtown San Francisco that works almost exclusively with corporate patients. Those work-ups often can be eliminated if primary care givers are properly educated about depression, Herrell said.

When properly diagnosed and treated, costs can be relatively low.

“The message is, ‘Let us help,’ ” Rapaporte said. “Let us train your (Employee Assistance Program) managers so there can be early identification and early intervention. This will save you money and it will save your good workers.”